Video and Transcript: Learn Exercises to Alleviate Knee Pain when Navigating Stairs

Hi! Dr. Orit Hickman here from Pain Science Physical Therapy.

And, I was asked to put together a video for addressing weakness and pain in the knee with going up and down stairs. So, I thought I would give you guys a few different exercises to give it a try and see how it works. And, let me know how it goes. 

So, the ones that I really like — the first exercise I really like, which is really very simple, it’s — believe it or not, it’s called a quad set. And, all it is is just stretch or strengthening the muscle right above the knee, which is your quadriceps muscles. And, the way to do that would be to — you could roll up a towel and put it right under the knee. But, all you’re going to do is gently tighten this muscle by pushing the knee down into the surface. And so, you can do this laying on your bed. You don’t have to get down to the floor, but if you’re able to get down to the floor, sometimes that’s a little bit easier. So, you just tighten this muscle, push down, and hold for about five seconds, and then release. And then, hold for about five seconds and release. And, hopefully this doesn’t cause any pain. If it does, you should probably stop and have it looked at by a physical therapist in person or on telehealth to make sure that you’re doing the exercise correctly or that it’s also the appropriate one for you. So, about five or ten repetitions of that exercise is a great way to start by waking up that quad muscle.

The next exercise that I like is a muscle — is an exercise that strengthens both the quad muscle and the hip flexors, which are important muscles to use for going up and down stairs. And, what you do is you’re going to combine, so you’re going to start with that first exercise, which is the quad set. And, you’re just going to go up and down about three to six inches off the ground or off the bed. Then, you try to hold and control that muscle. What you don’t want is for your knee to be bent as you lift and lower. So, you’re trying to keep that leg as straight as you can. And, I find that by pulling your toes back to your nose makes it a little bit easier, or rather the exercise is more targeted. So, it’s actually a little harder, so up and down, five to ten repetitions. Okay? So, that’s number two.

Number three is laying on your side, and you’re going to do an exercise that’s targeted for your butt muscles. So, we’re trying to target all the muscles that help to control the movement of going up and down stairs and just making sure that those muscles are awake, woken up, and working properly. So, bottom leg is bent. Top leg is straight. Toes are towards your nose, and you’re going to just do a little lift and lower. And, this exercise — I have my leg pretty good in line with my trunk when I do this. I don’t want my leg way in front, and I don’t want it super far back. It’s just — it’s just right in line with my trunk. And, where you should really feel that is in your butt muscles. So, lift and lower, five or ten times. Okay?

And, I like those three for laying down. There are plenty of other ones out there, but that’s a good place to start. The next is you actually want to do more of a targeted exercise. That’s more what we call functional. So, you’re actually doing the movement that you’re trying to get better at. So, if you have stairs and you’re trying to be better about getting up and down stairs, you want to start at the bottom step. You want to hold on to a railing or some other surface that you have some stability with. And, if it’s a specific leg that you’re having difficulty with, what I would recommend is you actually do these exercises on the opposite leg. So, for example, if I’m having difficulty with my right knee, I actually want to start on my left leg. And, the reason for that is it actually helps to train your brain to figure out, “Okay. What do I need to be doing on that leg?” And so, the more that you do this on the leg that doesn’t hurt and you think about what that movement will look like, feel like on the right leg, that should help with the — with the training process. So, what you’re going to do is you’re going to bring your left leg up onto the step. And, you’re going to come up, and then you’re going to lower back down. And, you’ll do this about five or ten times. 

And, it’s important for you to think about, “Okay. This is what I want to feel like when I do this on the right side.” What you don’t want to be thinking about is, “Wow! This is going to really hurt on the right side. I don’t know if my right leg can handle this.” If you start finding that you have a lot of anxiety and fear associated with the movement on the other leg, then there’s some other stuff that’s going on that we want to address, and physical therapy more specifically. You know how is your brain setting you up to do the movement because before I do this movement my brain has already executed the program. So, if my brain says, “Oh, this is easy. I know how to do this on the left. No big deal,” then it’s typically no big deal. It’s pretty easy. But, if I go to lift the right leg up and immediately my brain says, “This is a dangerous movement. I need to protect the leg,” you don’t have a choice. You’re going to do it differently on the right compared to the left. So, knowing where your brain is at when you’re about to do an exercise or a movement that is scary or uncomfortable for you is really important. 

So, I would do five or ten repetitions on the left thinking about, “I want to feel this on the right.” Then, switch to the leg that’s bothering me, my right knee in this case. And, practice doing up and down on the right. And, as you do this, the focus is on lowering down. It’s not actually on the up. It’s actually on the down. You want to come down with control because when you do that, you're really strengthening that quadriceps muscle. You're helping it get movement that you’re trying to get because, eventually, what you’re going to want to do is you’re going to want to come up, and then you’re going to want to come down the step. And so, practicing it this way with the foot behind the back, behind the leg gets you a little bit more comfortable with strengthening and using that muscle. 

And then, once you feel like it’s really easy for you to come up and then come down with a backwards step, then what you can do is practice going forward. And, the same idea is the case here where if I am holding, I want to practice doing this with my left leg lowering me down first. Okay? So, the leg that is left behind the step is the leg that is controlling the movement. So, if I have issues with my right leg, I’m going to want to do this on my left leg first. Five or ten repetitions lowering down, coming back up. Do this on the bottom step, lowering down, coming back up. And, once I feel comfortable with that, I want to practice that on the right. 

And, maybe you only start with one repetition. Maybe you only feel comfortable doing it one time, and you lower down and come up. And, that’s great. Give yourself time to get used to this. If you’ve had — you know — anxiety or fear with movement for a long period of time or you’ve had pain or even a history of fall, then you’re going to want to take it really, really slow and careful. 

So, let me know how it goes. And, I’d love to know whether or not that was a helpful video for you. So, if it was —you know —give me a thumbs-up and comment below so that I can learn a little bit more about what you guys — if you’re benefiting from these activities on videos, if you want to hear anything specific. Have a great day! Take care.

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